Basic Information
| Provider Information | |||||||||
| NPI: | 1093451338 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BREWER | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1221 S GEAR AVE | ||||||||
| Address2: | |||||||||
| City: | WEST BURLINGTON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 526551681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2176173873 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1221 S GEAR AVE | ||||||||
| Address2: | |||||||||
| City: | WEST BURLINGTON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 526551681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3197681000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2022 | ||||||||
| LastUpdateDate: | 06/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC3500X | 115590 | IA | N | Nursing Service Providers | Registered Nurse | Cardiac Rehabilitation | 363LF0000X | 115590 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.